Sustained Virologic Response to Antiviral Therapy for Chronic Hepatitis C Virus Infection: A Cure and So Much More

Oxford Journals > Medicine > Clinical Infectious Diseases > Volume52, Issue7 > Pp. 889-900

Clin Infect Dis. (2011) 52 (7): 889-900.
doi: 10.1093/cid/cir076

Brian L. Pearlman 1,3,4 and Nomi Traub 2,3

+ Author Affiliations

1 Center for Hepatitis C, Atlanta Medical Center, Atlanta, Georgia
2 Atlanta Medical Center, Department of Graduate Medical Education, Atlanta, Georgia
3 Medical College of Georgia, Department of Medicine, Augusta, Georgia
4 Emory School of Medicine, Department of Medicine, Atlanta, Georgia

Correspondence: Brian Pearlman, MD, FACP, Center for Hepatitis C, 285 Blvd NE Ste 140, Atlanta, GA 30312 (brianpearlman@hotmail.com).

Abstract

Sustained virologic response (SVR) is defined as aviremia 24 weeks after completion of antiviral therapy for chronic hepatitis C virus (HCV) infection. In analyses of SVR durability, the incidence of late relapse is extremely low (<1%). Histologic regression of both necroinflammation and fibrosis has been demonstrated in paired liver biopsy samples in SVR-achieving patients. More noteworthy is the sustained responder's favorable prognosis even with baseline cirrhosis; despite mostly retrospective analyses, relative to nonresponders or to those untreated, patients with SVR have significantly fewer liver-related complications, less hepatocellular carcinoma, and fewer liver-related deaths. Although HCV is associated with insulin resistance, successful eradication of HCV appears to reduce the risk of impaired fasting glucose and diabetes development. In summary, chronic HCV infection is curable with SVR attainment, and with cure comes improved liver histology and more favorable clinical outcomes, in comparison with patients who do not achieve the same therapeutic milestone.

Received September 10, 2010.
Accepted January 19, 2011

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